Teriparatide vs Thiamine

Head-to-head evidence comparison — which supplement is right for you?

Quick answerNo interaction data — ask a pharmacist

Teriparatide vs Thiamine: Thiamine has the stronger overall evidence (7.5 vs 7/10); the best pick depends on your goals. Take the 60-second quiz for a pick tailored to your goals.

Thiamine Edges Ahead

Thiamine wins 2 of 3 categories. Both are solid choices — the best pick depends on your specific goals.

Teriparatide1 win

Thiamine2 wins

Which is right for you? Take the 60-second quiz Open in the full comparison tool

Ter7.0

Teriparatide

Too few graded studiesLimited safety

B17.5

Thiamine

Too few graded studiesHigh safety

Evidence

Evidence Score

7/10

Studies: 307

Meta-analyses: 47

Level: Strong

Evidence Score

Best7.5/10

Studies: 187

Meta-analyses: 19

Level: Strong

Research findings

Verdict

Too few graded studies

Top outcomes

Bone healthToo few graded studies202
Fracture & skeletal outcomesToo few graded studies44
Safety profileToo few graded studies7

Verdict

Too few graded studies

2 of 2 studies with measurable effects showed benefit.

Top outcomes

Therapeutic & clinicalToo few graded studies155
Beriberi & Wernicke-KorsakoffToo few graded studies20
Glucose & metabolicToo few graded studies15

Dosage & timing

Recommended Dosage:

20 micrograms once daily by subcutaneous injection (the approved osteoporosis dose; PRESCRIPTION ONLY)

Warnings

PRESCRIPTION DRUG, NOT A SUPPLEMENT — an FDA-approved osteoporosis medication reserved for patients at high fracture risk; should only be used under a prescription and medical supervision.
HISTORICAL BOXED WARNING for osteosarcoma: teriparatide originally carried an FDA boxed warning and a 2-year lifetime-use limit because high lifetime doses caused osteosarcoma in RATS. A 15-year US postmarketing surveillance study (2003-2016) did not find an increased osteosarcoma incidence in treated adults, which does not establish zero risk. The EU Forsteo label limits total treatment to 24 months and says that course should not be repeated during a patient’s lifetime. In November 2020, the FDA removed FORTEO’s osteosarcoma boxed warning. The US label now says treatment beyond two years in a lifetime should be considered only if the patient remains at, or returns to, high fracture risk.
In the EU, Forsteo is contraindicated with metabolic bone disease other than primary or glucocorticoid-induced osteoporosis (including Paget’s disease and hyperparathyroidism), unexplained raised alkaline phosphatase, previous radiation therapy to the skeleton, and skeletal malignancy or bone metastases. The US FORTEO label instead places osteosarcoma-risk groups under an avoid-use warning: open epiphyses, metabolic bone disease such as Paget’s disease, bone metastases or skeletal malignancy, skeletal radiation and hereditary predisposition.
Can cause transient hypercalcemia and orthostatic (postural) hypotension — inject where you can sit or lie down for the first doses.
Requires a daily subcutaneous injection (a refrigerated pen) — a meaningful adherence burden.
Not for fracture HEALING — the evidence is for fracture PREVENTION and bone-density gain; the healing-acceleration literature is mixed.

Best Time:

Any time of day

Can take on empty stomach

Best Form:

Subcutaneous injection (prefilled pen)

Recommended Dosage:

50-100mg daily; 150-600mg benfotiamine for neuropathy

Warnings

Chronic alcohol use depletes thiamine
Deficiency can cause serious neurological problems

Best Time:

With food, Morning with other B vitamins

Take with food

Best Form:

Benfotiamine (fat-soluble, higher bioavailability)

Safety

Limited safety

Drug Interactions:

Digoxin (moderate)
Calcium / vitamin D supplements (mild)

Side Effects:

Hypercalcemia (transient)Orthostatic hypotension / dizzinessLeg cramps

Contraindications:

Osteosarcoma-risk conditions: in the EU (Forsteo) a contraindication with metabolic bone disease other than primary or glucocorticoid-induced osteoporosis (including Paget’s disease), unexplained raised alkaline phosphatase, previous radiation therapy to the skeleton, and skeletal malignancy or bone metastases. The US FORTEO label instead says to avoid use with open epiphyses, metabolic bone disease such as Paget’s disease, bone metastases or skeletal malignancy, skeletal radiation and hereditary predisposition
Pre-existing hypercalcemia or hyperparathyroidism

High safetyBest

Drug Interactions:

Loop diuretics (furosemide) (mild)
Digoxin (mild)

Side Effects:

Allergic reaction (rare, usually with IV administration)Mild GI upset

Contraindications:

Known allergy or hypersensitivity to Thiamine or related compounds

What you'll notice

🦴 Reduced vertebral fracturespositive

Over ~18-24 months of daily use

🛡️ Reduced nonvertebral fragility fracturespositive

Over ~18-24 months

📊 Bone-density gainspositive

Detectable by ~3 months

🧪 Transient hypercalcemiatrade-off

Hours after each dose

⚡ Energy Productionpositive

2-4 weeks

🧠 Nerve Supportpositive

4-8 weeks

🦶 Neuropathy Relief (Benfotiamine)positive

4-12 weeks

Key studies

Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis.

N Engl J Med (2001) · Rct · n=1637

Pivotal Fracture Prevention Trial: 1637 postmenopausal women with prior vertebral fractures randomized to PTH(1-34) 20 or 40 microg/day or placebo, median 21 months

Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial.

Lancet (2018) · Rct · n=1360

Head-to-head double-blind, double-dummy RCT of teriparatide 20 microg/day vs risedronate 35 mg/week in 1360 women with severe osteoporosis over 24 months

Teriparatide or alendronate in glucocorticoid-induced osteoporosis.

N Engl J Med (2007) · Rct · n=428

18-month randomized, double-blind, controlled head-to-head trial in 428 patients with glucocorticoid-induced osteoporosis

All Teriparatide studies

Dietary supplements for dysmenorrhoea

The Cochrane database of systematic reviews (2016) · Meta analysis · n=3101

Supplements versus other supplementsThere was no evidence of a difference in effectiveness between ginger and zinc sulphate (MD 0.02 points, 95% CI -0.58 to 0.62; one RCT, 101 women).

Evaluation of the Efficacy of the Addition of a Combination of Pyrimidine Nucleotides and Vitamin B1 and B12 to Standard Treatment in the Management of Painful Radiculopathy and in the Quality of Life of Patients

Nutrients (2024) · Rct · n=122

Both groups showed pain improvement, but the VAS reduction (control: 24.58 vs. experimental: 31.35) was not statistically significant.

Efficacy of B-vitamins and vitamin D therapy in improving depressive and anxiety disorders: a systematic review of randomized controlled trials

Nutritional neuroscience (2023) · Systematic review · n=2256

We identified 20 RCTs that matched all eligibility criteria, totaling 2,256 subjects, diagnosed with MDD, GAD, and depressive or anxiety symptoms.

All Thiamine studies

Dose-response curve

Teriparatide

No dose-response data

Thiamine

EffectivenessSide effect riskOptimal

Both points come from one phase III trial of benfotiamine, a fat-soluble thiamine derivative, in 165 patients with diabetic polyneuropathy (BENDIP, PMID 18473286): 300 mg or 600 mg a day or placebo for 6 weeks. The Neuropathy Symptom Score differed between groups in the per-protocol analysis (p = 0.033) and narrowly missed significance in the intention-to-treat analysis (p = 0.055), and the Total Symptom Score did not differ. Improvement was more pronounced at 600 mg, and both doses were well tolerated, so 600 mg, the highest dose tested, is the ceiling. Thiamine hydrochloride doses were not tested and cannot be read off this axis, and one 6-week trial cannot establish a minimum or optimal dose.

AI-estimated from published studies. Interpret as directional guidance.

Frequently asked questions

Is Teriparatide better than Thiamine?

Thiamine has a higher evidence score (7.5/10 vs 7/10) and wins in 2 of 3 categories.

Can I take Teriparatide and Thiamine together?

No documented interaction was found in the data searched. This does not establish that this exact combination is safe.

Related comparisons

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Still deciding between Teriparatide and Thiamine?

The right pick depends on your goals. Answer a few quick questions for a personalised recommendation — or dig into the full evidence on each.

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Warnings

PRESCRIPTION DRUG, NOT A SUPPLEMENT — an FDA-approved osteoporosis medication reserved for patients at high fracture risk; should only be used under a prescription and medical supervision.

HISTORICAL BOXED WARNING for osteosarcoma: teriparatide originally carried an FDA boxed warning and a 2-year lifetime-use limit because high lifetime doses caused osteosarcoma in RATS. A 15-year US postmarketing surveillance study (2003-2016) did not find an increased osteosarcoma incidence in treated adults, which does not establish zero risk. The EU Forsteo label limits total treatment to 24 months and says that course should not be repeated during a patient’s lifetime. In November 2020, the FDA removed FORTEO’s osteosarcoma boxed warning. The US label now says treatment beyond two years in a lifetime should be considered only if the patient remains at, or returns to, high fracture risk.

In the EU, Forsteo is contraindicated with metabolic bone disease other than primary or glucocorticoid-induced osteoporosis (including Paget’s disease and hyperparathyroidism), unexplained raised alkaline phosphatase, previous radiation therapy to the skeleton, and skeletal malignancy or bone metastases. The US FORTEO label instead places osteosarcoma-risk groups under an avoid-use warning: open epiphyses, metabolic bone disease such as Paget’s disease, bone metastases or skeletal malignancy, skeletal radiation and hereditary predisposition.

Can cause transient hypercalcemia and orthostatic (postural) hypotension — inject where you can sit or lie down for the first doses.

Requires a daily subcutaneous injection (a refrigerated pen) — a meaningful adherence burden.

Not for fracture HEALING — the evidence is for fracture PREVENTION and bone-density gain; the healing-acceleration literature is mixed.